NHS doctors are planning to take industrial action on 21 June over pension reforms that would see them working until they’re 68 and paying twice as much in contributions as other public sector staff on a similar pay-grade, for the same eventual pension.

The majority of GPs, consultants, junior doctors, staff, associate specialists and specialty doctors as well as public health and community health doctors who voted in last month’s ballot said they were even prepared to go on strike, but the British Medical Association has ruled that out: ‘doctors will ensure that patient safety is protected’ on the day by continuing to supply urgent and emergency care, only postponing non-urgent cases.

Doctors only finished renegotiating their current pension deal in 2008, when they agreed to a large increase in employee contributions, and that they and not the taxpayer would take on reponsibility for future rises in the cost of the scheme. According to the BMA, the current deal is sustainable and the proposed reforms entirely unnecessary. It first rejected them in December, and its repeated offers since then to renegotiate the deal have been ignored by the government. The decision to take industrial action was a reluctant one. The BMA council chairman, Hamish Meldrum, said:

We have consistently argued that the Government should reconsider its position, and even at this stage we would much prefer to negotiate a fairer deal than to take action.

Aneurin Bevan famously said that he won the doctors over to supporting the NHS because he ‘stuffed their mouths with gold’. In that tradition, ministers have historically kept up generous financial incentives for doctors to work for the NHS rather than gambling with the future of the system by risking their defection to the private sector.

The last time the BMA called for industrial action was in 1975, when consultants were set to work to rule and suspend ‘goodwill’ activities in protest against contracts that they feared would stop them practising privately. Barbara Castle made concessions to allow them to continue their private work and the action was called off. Later that year, junior doctors reached an agreement with the government over pay and conditions after a month of providing emergency care only.

But the current government isn’t similarly motivated to throw more money at doctors, and is therefore unlikely to give in to the BMA’s demands, especially since it has finally managed to engineered a PR battle over the NHS that it may be able to win. ‘Shame of £100k doc strike vote,’the Sun said last week. On Radio 4, Andrew Lansley said:

I don’t think the public will remotely understand that a proportion of doctors who are amongst the best paid in the NHS and will continue to have a pension scheme that is amongst the best available anywhere should put patients to any degree of inconvenience.

And he told ITV that industrial action ‘won’t change anything on the pension deal: it will only cause inconvenience for patients.’

But far more – and permanent – inconvenience for patients could result from the government’s refusing to budge. Commenting on an article about the scheduled industrial action in the Health Service Journal, one reader notes that a GP’s income

has fallen by 15% in the last year AND she is being asked for significant extra amount in pension contributions and being asked to work for considerably longer.

Not a great incentive for a highly qualified medical professional to continue to work in the NHS is it?

If nothing is done, I think we will see a repeat of what has happened to NHS dental services with the rise of private General Practice.

And how convenient it would be for the government if the NHS fell apart apparently from a lack of support in the medical profession rather than because of any legislation for which it might be held accountable.

Ah! the PFI deals. Just another aspect of privatisation. What amuses me about the anti-PFI lobby is the assumption that somehow all these projects and management services that have been provided by the PFI would have been provided more efficiently if the government had done it itself as if its projects always appear on time an don budget. You only have to look at what happened to the Tube PFI to see that there is value in passing on the risk.
Now of course if you’re complaining about shoving the financing of these things off balance sheet that’s another matter altogether.